A severe toothache can make it difficult to eat, sleep, work or concentrate on everyday activities. While tooth pain can sometimes be caused by something minor, severe or persistent toothache may be a sign of an underlying dental problem that needs professional attention.
Toothache can occur because of tooth decay, dental infection, a cracked tooth, gum problems, wisdom teeth or dental trauma. The type and severity of the pain can sometimes provide clues about what may be happening, but only a dental examination can determine the exact cause.
If you’re experiencing severe tooth pain, understanding the possible causes can help you know when it’s time to seek dental care.
What Does a Severe Toothache Feel Like?
Tooth pain can feel different from person to person. You may experience:
- Sharp or stabbing pain
- Constant or throbbing pain
- Pain when biting or chewing
- Sensitivity to hot or cold foods and drinks
- Pain that spreads towards the jaw, ear or head
- Swelling around the tooth or gums
- Pain that becomes worse at night
- A bad taste or unpleasant smell in the mouth
Toothache may also be accompanied by gum or facial swelling, bleeding or increased sensitivity.
Common Causes of Severe Toothache
1. Tooth Decay
Tooth decay is one of the most common causes of tooth pain.
When decay progresses deeper into the tooth, it can eventually affect the inner pulp where nerves and blood vessels are located. This can lead to increasing sensitivity and significant pain.
A cavity may initially cause little or no discomfort, which is why regular dental check-ups are important even when your teeth feel fine.
If decay becomes extensive, treatment may involve a filling or, depending on the condition of the tooth, more extensive dental treatment.
2. Dental Infection or Abscess
A dental abscess occurs when an infection develops around or inside a tooth. It can cause severe, throbbing pain and may be accompanied by swelling, fever, a bad taste in the mouth or pain when biting.
A dental abscess generally requires prompt professional treatment and should not simply be left to settle on its own. Treatment depends on the source and severity of the infection and may include drainage, root canal treatment or removal of the affected tooth.
3. A Cracked or Damaged Tooth
A cracked tooth can cause sharp pain, particularly when biting or chewing.
Sometimes the crack is difficult to see without a dental examination. Pain may also occur when you eat something hot or cold.
Dental injuries, biting hard foods or existing weakness in a tooth can contribute to cracks or fractures.
The appropriate treatment depends on the location and extent of the damage.
4. Inflamed or Infected Tooth Pulp
The pulp is the soft inner part of your tooth containing nerves and blood vessels.
When the pulp becomes severely inflamed or infected, it can cause intense tooth pain and sensitivity. In some cases, the pain can continue even after the original trigger, such as hot or cold food, has been removed.
Depending on the condition of the tooth, root canal treatment may be recommended to remove the damaged or infected pulp and preserve the tooth.
5. Gum Disease
Tooth pain isn’t always caused by the tooth itself.
Gum disease can cause inflammation, bleeding, swelling and discomfort around the teeth. In more advanced cases, infection around the supporting structures of a tooth can contribute to pain and other dental problems.
If you notice persistent gum bleeding, swelling or loose teeth alongside tooth pain, it’s important to have your mouth assessed by a dentist.
6. Wisdom Tooth Problems
Wisdom teeth can sometimes cause pain when they are growing, impacted or only partially erupting.
Food and bacteria can become trapped around a partially erupted wisdom tooth, potentially causing inflammation and infection.
Wisdom tooth problems may cause:
- Pain at the back of the mouth
- Swollen or tender gums
- Difficulty opening your mouth
- Pain when chewing
- Bad taste or bad breath
- Swelling around the jaw
Wisdom tooth pain should be assessed by a dentist to determine the underlying cause.
7. Dental Trauma
An accident, sporting injury or other impact can damage a tooth and cause sudden pain.
Even if the tooth doesn’t appear visibly broken, trauma can affect the structures inside it.
If you’ve experienced an injury and developed significant tooth pain, sensitivity, looseness or swelling, arrange a dental assessment as soon as possible.
8. A Loose or Damaged Filling or Crown
Existing dental work can sometimes become damaged, loose or worn over time.
A damaged filling or crown can expose sensitive parts of the tooth and lead to pain when eating, drinking or biting.
Your dentist can assess the restoration and determine whether it needs to be repaired, replaced or whether the tooth underneath requires further treatment.
Why Does My Toothache Get Worse at Night?
Many people notice that tooth pain feels worse at night.
When you’re lying down, changes in blood flow and pressure around the head and the absence of daytime distractions may make dental pain feel more noticeable.
However, severe toothache that repeatedly keeps you awake should not be ignored.
If your pain is persistent or getting worse, a dental examination can help identify the underlying problem rather than simply masking the symptoms.
When Is a Toothache a Dental Emergency?
Not every toothache requires emergency care, but severe dental pain, significant swelling or signs of infection should be assessed promptly.
You should seek urgent dental care if you have:
- Severe or persistent tooth pain
- Facial or jaw swelling
- Fever
- Significant pain when biting
- A bad taste associated with swelling or infection
- A broken or severely damaged tooth
- Pain that isn’t improving
- Difficulty opening your mouth
Healthdirect recommends seeing a dentist if toothache lasts more than two days or does not improve with pain relief.
Seek emergency medical care immediately if:
You have dental or facial swelling that causes difficulty breathing or speaking, or swelling around the eye or neck. These symptoms can indicate a potentially serious infection requiring urgent medical attention.
Can Severe Toothache Go Away on Its Own?
Sometimes tooth pain may temporarily disappear, but that doesn’t necessarily mean the underlying problem has been resolved.
For example, an infection or damaged tooth can continue to deteriorate even if the pain temporarily decreases.
That’s why it is important to identify what is causing the toothache, rather than simply waiting for the pain to disappear.
What Can You Do Until You See a Dentist?
If you’re waiting for a dental appointment, you can take some simple steps to help manage discomfort:
- Keep your mouth clean with gentle brushing.
- Choose softer foods that are easier to chew.
- Avoid foods and drinks that trigger your pain, particularly very hot or cold items.
- A cold compress against the outside of the face may help with swelling and discomfort.
- Speak with your pharmacist or healthcare professional about appropriate pain-relief options for you.
Pain relief can help manage symptoms temporarily, but it does not replace dental treatment when an underlying dental problem is present.
It is also important not to assume that antibiotics are always the answer. Dental guidelines generally recommend treating the underlying dental cause rather than using antibiotics for most cases of dental pain without systemic involvement.
How Is the Cause of Toothache Diagnosed?
Your dentist will usually ask about your symptoms and examine your teeth, gums and surrounding tissues.
Depending on your symptoms, dental X-rays may also be recommended to help identify problems that cannot be seen during a visual examination, such as infection around the tooth root or deeper decay.
The treatment will depend entirely on the underlying cause.
It may include:
- Dental fillings
- Root canal treatment
- Treatment for gum disease
- Repair or replacement of a dental restoration
- Treatment of an abscess
- Tooth removal when a tooth cannot be restored
Don't Ignore Severe Tooth Pain
A severe toothache is your body’s way of telling you that something may need attention.
Whether the cause is tooth decay, infection, a cracked tooth, gum disease or a wisdom tooth problem, getting the underlying cause diagnosed early can help prevent the problem from becoming more complicated.
If you’re experiencing severe or persistent tooth pain, speak with a dental professional rather than continuing to manage the pain on your own.
Need dental care for a painful tooth? Contact All in One Dental to arrange an assessment.